Like so much now happening in the National 'Elf I fear
there is little we can do about it except shrug.
The GMC will prosecute us docs for breaking the rules
it sets out in those vague little booklets with pretty
covers. Bu99er all can it do about breaches of
confidence by the government clerks who constitute our
monopoly employer.
If a patient complains he will get one of those
fob-off letters we have come to know so well. I'm not
sure there is any effective remedy for him, neither
legal nor disciplinary.
Anyway, soon the patients' secrets will all be on the
national computer database and we have had a recent
spectacular display of how insecure NHS computers can
be.
I've always refrained from writing down embarrassing
parts of a patients' history when they are not
essential.
Perhaps we should be required to warn them that
anything they say may be taken down and used in
evidence against them.
Alan (shrugging)
--- Rowley Cottingham <[log in to unmask]>
wrote:
> Date: Thu, 3 May 2007 20:48:09 +0100
> From: Rowley Cottingham <[log in to unmask]>
> Subject: Notes and their ownership
> To: [log in to unmask]
>
> I think we have discussed release of patient notes
> at Police request here
> before. Some years ago BAEM reached an agreement
> with ACPO on which notes
> may be released to the Police without patient
> consent and laid down strict
> criteria, which were essentially that a serious
> arrestable crime (eg murder,
> attempted murder) had been committed. The definition
> was swept away in the
> most recent PACES legislation, but I thought the
> offences still were the
> same.
>
> The matter came up at our routine Police liaison
> meeting today, and to say
> that things have changed a bit is somewhat litotic.
> I welcome correction,
> but as I understand it, the Police now have only to
> apply to the local
> Security Management Service of the Trust while
> investigating any crime, and
> providing it is not a fishing trip the notes can be
> released - without as
> far as I could ascertain any reference to medical
> staff. It suggests that
> our notes, once made are no longer our property to
> guard, which contradicts
> the GMC guidance on notes:
>
> 20. You must not disclose personal information to a
> third party such as a
> solicitor2, police officer or officer of a court
> without the patient's
> express consent, except in the circumstances
> described in the paragraphs
> which follow.
>
>
> Disclosures in the public interest
>
> 22. Personal information may be disclosed in the
> public interest, without
> the patient's consent, and in exceptional cases
> where patients have withheld
> consent, where the benefits to an individual or to
> society of the disclosure
> outweigh the public and the patient's interest in
> keeping the information
> confidential. In all cases where you consider
> disclosing information without
> consent from the patient, you must weigh the
> possible harm (both to the
> patient, and the overall trust between doctors and
> patients) against the
> benefits which are likely to arise from the release
> of information.
>
> 23. Before considering whether a disclosure of
> personal information 'in the
> public interest' would be justified, you must be
> satisfied that identifiable
> data are necessary for the purpose, or that it is
> not practicable to
> anonymise the data. In such cases you should still
> try to seek patients'
> consent, unless it is not practicable to do so, for
> example because:
>
> * the patients are not competent to give consent
> (see paragraphs 28 and
> 29); or
> * the records are of such age and/or number that
> reasonable efforts to
> trace patients are unlikely to be successful; or
> * the patient has been, or may be violent; or
> obtaining consent would
> undermine the purpose of the disclosure (eg
> disclosures in relation to
> crime); or
> * action must be taken quickly (for example in
> the detection or control
> of outbreaks of some communicable diseases) and
> there is insufficient time
> to contact patients.
>
> 24. In cases where there is a serious risk to the
> patient or others,
> disclosures may be justified even where patients
> have been asked to agree to
> a disclosure, but have withheld consent (for further
> advice see paragraph
> 27).
>
> 25. You should inform patients that a disclosure
> will be made, wherever it
> is practicable to do so. You must document in the
> patient's record any steps
> you have taken to seek or obtain consent and your
> reasons for disclosing
> information without consent.
>
> 26. Ultimately, the 'public interest' can be
> determined only by the courts;
> but the GMC may also require you to justify your
> actions if a complaint is
> made about the disclosure of identifiable
> information without a patient's
> consent. The potential benefits and harms of
> disclosures made without
> consent are also considered by the Patient
> Information Advisory Group in
> considering applications for Regulations under the
> Health and Social Care
> Act 2001. Disclosures of data covered by a
> Regulation4 are not in breach of
> the common law duty of confidentiality.
>
> Am I missing something here, or are doctors and the
> GMC's safeguards being
> bypassed?
>
> Best Wishes,
>
> Rowley.
>
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